Archive | January, 2015

Breastfeeding.  Why the big deal?

Breastfeeding. Why the big deal?

Posted on 29 January 2015 by hulda


I have been a mother for longer than I have been a midwife.  And before I was a midwife, when I was a nurse, I remember thinking:  What is the big deal about breastfeeding? Everyone breastfeeds, right?  But if not, then surely there is a reason.  But actually, I had no real professional knowledge about it.  Around me, everyone breastfed. For a long time.  For months and over a year.

Maternity leave makes a difference for breastfeeding.

The maternity leave in Iceland is 3 months for mums, 3 months for dads and 3 months for either mum or dad.  Total, 9 months, on 80 % salary.  When you start to work, you can usually pump or go home for lunch to breastfeed. Or bring the baby into the meeting and feed while you do what you have to do.  No one raises an eyebrow. How can you have a baby and not feed it when it is hungry?  Of course you go home from work, baby needs you.  Government pays, mostly.  This is their family friendly policy.  Not perfect, and with many other problems, but maternity leave is good.

The partner – and friends – make a difference for breastfeeding.

I cannot really remember having seen any of my friends’ breasts.  When they breastfed I mean.

I have not asked my husband but I am going to guess that he would have found it mildly uncomfortable to see my friends’ breasts when they were feeding, but probably he just looked away if there ever was a moment when he could have caught a glimpse of flesh before the baby latched on.  But it did not bother him.  He was not overly in favor of breastfeeding, as in an advocate.  But he would never have dreamed of disagreeing to it.  Breasts are for babies who are just born, and all.  Why would you even discuss this?
Or whatever.
Most partners realize that breastfeeding is also an investment in health.  They are educated and up to date.

Doctors and nurses are not experts in breastfeeding.

Bottom line is that breastfeeding was for me at the age of 24 in Iceland, no big deal.  It also was no big deal when my second baby was harder to breastfeed than the first and I gave her some formula.  Not great if you ask me actually, but I did it as I had not the information or push from people around me to do it, and not enough personal enthusiasm myself.  I was a nurse and knew quite a bit about nutrition.  But nurses, and doctors also, are not really educated about breastfeeding but for around 1 to 2 hours of all their training.  Remember, their 4 – 10 years of training.  So they are generally not very good when you need advice and help about this matter. This was good and bad for me when I had troubles; I was not helped to push through to continue, which actually I think I could have easily done.  And good that at least when I found myself at that point – needing to give formula – I did not feel awful about it.  My poor husband was so relieved when this solution was found, we had tried a lot of things but somehow could not figure it out.  But he was helpless and sad when he saw me sad.bekkabrjostagjof


Yesterday I posted a link about “mummy wars” without realizing that of course, this video was a great psychology trick created by a formula company.  I think I did not watch it to the final end so I did originally not see it, but it had already planted its message in me.

What was interesting in it was how cleverly it was done (of course with the interests of the formula company in mind), by using what many of us are thinking nowadays, that there is actually a big sandbox war out there sometimes, between groups of mums and dads.  About lifestyle, sleeping, feeding and all of the stuff I have blogged about many times.  Of course people watch this formula company video because they recognize something from this video; their friends, other parents or themselves.

And, predictably in the end, everyone is united in that we should all be friends and it is all about the babies, and it is.

But someone pointed out and this is very true, that it is this clever way of reaching out to us that has become one of the problems for new parents.

Breastfeeding is normal.

Breastfeeding is not anymore  “just” the obvious choice.  In fact, the obvious choice for people nowadays is to “choose”.  Choose between:  breastfeeding or work.  Breastfeeding and the dad is out of the question in the caregiving.  Or else, his role is to change the diapers and burp. Breastfeeding or sleep.

The truth is that there is far too much analyzing and pushing and arrogance and and and… I don’t even have a word for it, out there.

Babies are born to breastfeed.  Breasts are there and they produce milk for 99 percent of those that give birth. Breastfeeding is recommended for all babies as the main source of nutrition for babies until the age of 6 months.  Then, it can be continued for as long as the mother wishes.

There are other ways of feeding a baby but there is nothing that will fully replace the milk.  Just like nothing will fully replace an apple.  Not apple juice with “pulp” in it.

There are people who do not breastfeed, for a good reason.

For those that wish to breastfeed, in the current world we live in, unfortunately, we need breastfeeding advocates.  Pushing for it all the time, and we need education and endless support.  We need not nurses and doctors to be the main support for the new parents, but midwives and lactation consultants and health visitors and then possibly nurses and doctors if they are particularly interested in the breastfeeding and specifically educate themselves.

We also need partners, grandparents and employers and everyone else in the community to stop bitching and secretly being against breastfeeding.  Not that everyone is, but those that do, they are doing damage.  We need the world to understand that breastfeeding is and should be the norm and it should never have to be stopped until both the mother and / or the baby does not want to do it anymore.  Not because of work, exposure, grandmothers’ very generous reminders of that they “never had enough milk”, or helpful people suggesting that sleep will never return to normal until breastfeeding is stopped.

We also need to understand that many people have a very hard time with breastfeeding.  There are many things that can be difficult.  We don’t all cope the same and some babies are having a harder time, some sleep less and some more…..each family, baby and person has different things to cope with.

I strongly believe that everyone should, like Nike suggests, just do it.  That there should never be any suggestion of anything else.  Not even a choice.  Of course you just do it.  And have people around you who also do it.  Have an employer that understands that you actually do a better job at work when you show up happy and maintain that happiness when your 3 month old that you left at home is happy and well fed.  You may even stay longer at work as a result.  And a partner that just does not even talk about it.  Just leaves it.  Or is very helpful, if he is that type.

Then first, will those that actually cannot breastfeed, or choose not to, for whatever reason, do so without this horrible sandbox war happening, this competition of who is better than the next etc., (pretending it is all about the children), stop, and those that actually want to breastfeed properly focus on doing just that, instead of debating which is better and who is a better parent.

This is not easy.

I spend half my working hours talking to parents, mothers and fathers that are either full of guilt or worries, or both.  Mostly because of other people and their opinions.

How can you talk about all of what I have said above, to the one that has had to give up breastfeeding or give additional formula milk to their baby, without them feeling guilty?  It is the same as talking about normal childbirth to the woman who just had to have a C section, how can you remind her over and over again that a vaginal birth is probably better for both mother and child, without her feeling just awful?  Believe me, it is very very hard. I feel very sorry for them and I understand how hard this is for them.

There is enough negative in this world already and we need not to make life harder for ourselves or those around us.

Give support.  You matter.  Yes you.

Like I said in the beginning, breastfeeding is normal and everyone should be supported to feel that way. Those that run into troubles with it and feed their babies by other means should be free to do so without the finger pointing of others.  There is a reason for why we do things the way we do them and we are all adults.  I have seen people at the point of breaking and we always must weigh the options against each other.  Sometimes, simply, the formula is a better choice than continuing to breastfeed and there is no but about it.  That a dad feeds a baby expressed milk from the bottle or formula, does not make a baby’s life worse.  It may make it much better.  It may continue the breastfeeding for much longer and it may well be an educated choice.

There are mums here that have no support from their workplace to breastfeed.  And 8 weeks of maternity leave.  This is of course totally unacceptable.  If you are an employer or a co-worker, please do what you can to make it easier in the workplace for a new mother to breastfeed her baby.

We need advocacy everywhere about breastfeeding until the world gets better.  Employers, grandparents, partners, kids, mums and everyone needs to understand that breastfeeding is the right of a new baby and its mum.  The environment needs to be supportive of it.  Unfortunately those that advocate for breastfeeding have been labeled my many as “breastfeeding Nazis” or “hippies” but please… immature.

While we are out there fighting, the formula companies win.  So please stop.
Can everyone just get on with it and make it normal.   Not “natural”.   Just the norm.

Consultation with the midwives, available on Skype (face time or other platforms), over the phone or in the office. Click here to book. More information about our services on our website.



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Singing to babies

Singing to babies

Posted on 20 January 2015 by Kristrun


My children, Johanna and Tomas

On my list of things to do has been to write an article about the importance of singing to babies and children but I have never got round to finalising it. Then I found this – a very simple way of starting to communicate through singing during your pregnancy. Choose a song and sing it regularly throughout your pregnancy and then use it to soothe the baby once it arrives into the big wide world!

Talking, singing, rocking, soothing and comforting is our role. Start very early, don’t feel silly about it – it will work. Then continue. The rhythm, the rhyming, the voice creates a foundation for developing language skills. It also soothes and creates security.

I have always used singing with my children from when I was pregnant. I rocked them to sleep when they were anxious and crying. I sang to them through the long nights of unexplained crying. I sang to them through teething and all the restlessness that comes with the first year of being alive.

They are now almost 4 and 6. To this day, they ask me to carry them and sing to them if they are stressed, scared or anxious. And I do, and it still works.

This lady agrees with me and in the video are some great samples of how it works with newborn infants.



Consultation with the midwives and consultants, available on Skype (face time or other platforms), over the phone or in the office. Click here to book. More information about our services on our website.

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Meeting women on their terms through midwifery

Meeting women on their terms through midwifery

Posted on 14 January 2015 by Kristrun

Hulda og Jo CharterDear all

As some of you may know, we are celebrating Annerley´s 20th birthday this year.  This is a huge milestone for a clinic like ours, which now consists of a team of 14 professionals – all of whom have worked hard to build up our company.  We are fortunate to have an excellent reputation in Hong Kong and globally, and many of our midwives and nurses are active participants in conferences, workshops and professional services around the world.

None of this would have happened if it wasn’t for Ann Illingworth, the midwife who founded Annerley in 1995 – six years before I arrived in Hong Kong. Ann, who was a mother of six and had just retired as a sister in charge of a maternity ward, set up home-visiting, breastfeeding services and antenatal classes in Hong Kong which quickly became popular, due to her personal but very practical approach. Ann was a kind person who actually spent time with the women and made them feel like they had their mother with them, while at the same time providing professional care. It was appreciated in fast paced Hong Kong, and many partners were very grateful to Ann, for taking good care of their wives, when they needed to go to work shortly after their child’s birth.  In fact, I still meet people who remember her and it is always with fondness.

When I came to Hong Kong in 2001, it was not easy to step into Ann’s shoes. I knew not half of what she knew and it took me a while to settle in. But soon after arriving, I bought the company from Ann and changed a few things, including the name that previously was Annerley Community Midwifery Services – to Annerley Midwives.  I also set up a clinic in Central, and founded a slightly different type of business, based on the proprietorship that Ann had run. Annerley slowly became a bigger team and since 2003 when our first clinic opened, we have had over 40 midwives and nurses work with us and we still keep in contact with most of them, even long after they have left Hong Kong.

During my 14 years here, I have often asked myself what we are trying to achieve – what is our vision and goal? Not that it isn’t clear in my mind, but we do live in an ever-changing environment and we all need to keep abreast of current trends and norms. That said, I feel that I regularly need to remind myself that, despite our changing world, fundamentally, nothing has changed in what Annerley has to offer, which is basically:

To meet women on their terms

This requires that we are professionally updated and able to always provide evidence-based care but that we tailor to the needs of each woman, of each family. This can be a challenging task in an environment where people, both the professionals, and the families, come from different backgrounds and have different views on things. This is however, what we pride ourselves in doing well.  It is also one of the things that Hong Kong sometimes lacks, so it is gratifying to be able to offer personal and professional care that is well received. We have made every effort to create our centre in Central in such a way that everyone is welcome there and as many of you know, the mum & baby mornings that now are three days a week, are often busy, but a welcome oasis to come to.

It has not always been easy to go against the mainstream in Hong Kong, and there is no other private midwifery clinic like ours in this city so it is not a form of service that everyone understands. For most of us though, it is the standard for women in normal pregnancies to be cared for by midwives and pretty much every research that there is about outcomes and satisfaction regarding maternity care shows that continuity of care is important. So we have kept going through all these years and we hopefully will for a long time more. We will continue to be a bit old fashioned and perhaps a little motherly, but with the latest research and information relevant to new families and as you all have seen, we are making full use of the different social media to send out our messages and information around the world. We much appreciate your participation in our Pinterest, Instagram, facebook and google plus pages and hope that you, just like us, enjoy these new platforms.

In the year of 2015, our anniversary year, we will have different offers, giveaways and prizes each month to celebrate and to mark this important milestone. Amongst other things we will hold our very own Annerley family ‘walk & picnic’ for all the families that can join us and we will also have a Blooming Bellies session soon, that many of you know from our previous years.

I would like to dedicate this letter to Ann Illingworth who unfortunately passed away last year.  Equally, I want to thank you all, our Annerley Families for your ongoing support and loyalty.  We would really not be here without you and we hope that our partnership will be ongoing for many more years to come.

I attach a few pictures from my early years in Hong Kong, from the days when I wore a uniform and our antenatal class participants sat on the floor.

Warmest regards,

Hulda Thorey,

Consultation with the midwives, available on Skype (face time or other platforms), over the phone or in the office. Click here to book. More information about our services on our website.

Midwife and Director.

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Pelvic floor education – by Eugenie

Pelvic floor education – by Eugenie

Posted on 13 January 2015 by Kristrun


While giving birth is usually the most momentous time in a woman’s life, the nine months of pregnancy and the labour that follows have a significant impact on your pelvic-floor. The baby’s weight puts pressure on it, the increase of hormones (oestrogen and relaxin), and finally the birth itself will stretch the muscles. The combination of these factors will lead to a loss of tone and the muscles may not be able to play their role as before. This is unavoidable and if left untreated, can lead to serious consequences (incontinence, prolapsed womb, back pain, reduced sexual sensation). But although it is unavoidable, it is not irreversible. Labor can cause pinched nerves, check out Neuropathy Relief Guide to help get rid of the nerve pain.

Pelvic-floor re-education will allow you to regain the strength and tone of your muscles and therefore will allow you to avoid suffering these complications in the future.

Your perineum plays a very important role: it is the muscle supporting the womb and the bladder, and it’s tone allows continence by closing the sphincters (uthrethra, vagina and anus). And finally, it is the base for good back health. A stretched perineum will not be able to maintain all of those functions as well as reducing normal sexual sensation.

When is pelvic floor re-education necessary?

There is growing support in favour of beginning to exercise before the birth (antenatal). Your awareness of this muscle will facilitate the labour and reduce the risk of a tear (episiotomy).

After childbirth (postnatal), it is best to wait at least six to eight weeks before starting any re-education or sports. It is very important to not start any abdominal re-education with a weak pelvic-floor because it would increase the stretch of the perineum and increase such symptoms as incontinence. After these six to eight weeks, you may start your pelvic floor re-education whenever you feel ready for it, even years later you will still be able to benefit from it. The most common re-education techniques to treat perineal muscle weakness and incontinence are pelvic floor exercises.


Every pelvic floor re-education starts with an assessment and check up of the strength of your perineum and of your level of awareness of it. Following the check up, the midwife will determine a personalized treatment (pelvic floor exercises +/- electrostimulation) based on your medical background, the course of your pregnancy and the method of childbirth as well as on your level of awareness of your muscles. Finally she will show you the exercises that you will do between the sessions in order to increase the benefits of the treatment. A maximum of 10 sessions is required.


Click here to book a treatment or email to

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Safety in the car

Safety in the car

Posted on 13 January 2015 by Kristrun

Safety in the carMost parents travel with their babies in a car even in the first week of their lives. Immediately then, they need to take care of their child’s safety, which usually can only be secured by using a car seat, if you have no plans of selling your car.

Car seats:

According to the laws of Hong Kong, all newborn babies should be seated in a specially made infant car seat during a car ride.  This means that if you intend to travel with your child in either your own car, or in a taxi, it would be recommended to buy the car seat even before your baby is born.  Even though some other travel arrangements may be made, such as special baskets, or a baby carrier, nothing else has been proven to provide the baby with an adequate level of safety.

Car seats that are meant for, and are safe for newborns, have the baby’s face turning to the opposite direction of that in which the car is heading.  Many of them are most easily fitted into the front seat of the car, but nowadays drivers need to be extremely careful to make sure that an airbag (safety equipment for the car) is either not installed, or is deactivated, since this can cause danger to the baby if it inflates during a collision.

We recommend parents to have their babies in the back seat of the car, facing the back.  Make sure when buying a car seat that you are buying a quality brand that is recommended by a professional.

Other methods of travelling with children in cars:

If, for some reason, you do not have the opportunity to use a car seat when travelling with a child, for example in a taxi, you are advised to use a baby carrier that holds the baby tight against you, but with the seat belt between you and the child.  This is not as safe as travelling with a car seat of course, and will not provide adequate protection if you are involved in a collision at speed, but is your second best option.

2010 Annerley/ Hulda Thorey, updated in December 2014

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Safe ways to swaddle a newborn

Safe ways to swaddle a newborn

Posted on 13 January 2015 by Kristrun

Instgram Swaddling Conchita (1)

Most weeks, I get asked whether or not you should swaddle a baby.  My general response is if you are talking about a tight swaddle in which the baby cannot move and thereby increasing the risk of over-heating, I would say NO. Then I get asked about the various swaddling products on the market. Swaddling whereby a baby can move its limbs (and not overheat) is safe swaddling and here I would say YES.

I once had to give evidence in court concerning the devastating loss of a child. Having had to stand in court and tell a judge that I had advised the family not to tightly swaddle, I can assure you this is not advice I give on a whim.  I would not wish the loss of a baby on anyone nor the associated guilt that you may have contributed in any way to it.

So the absolute DO NOTs are:-

  1. Don’t swaddle so tightly that the arms and legs cannot move.
  2. Don’t swaddle with several layers or a thick blanket so there is a risk that baby overheats.
  3. Don’t place a swaddled baby on their front.
  4. Don’t swaddle a baby who does not want to be swaddled.
  5. Don’t swaddle a baby who is able to roll.

And if you DO want to swaddle:-

  1. Swaddle safely so that baby can move their legs freely.
  2. Swaddle in a way with either a swaddle product or light swaddle that the baby can move his/her arms and not overheat.
  3. Check the baby’s chest and back are warm, and that the baby is not overheating.
  4. Place baby on his back. Do not swaddle if the baby does not like it.
  5. Stop swaddling if the baby is able to roll.
  6. So my conclusion is that it is fine to swaddle safely, but make sure you understand what that means, and do not hesitate to ask if you need any clarification.

Wishing you lots of happy and safe times.

Conchita Amende

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